Refeeding Syndrome in Patients Receiving Parenteral Nutrition Is Not Associated to Mortality or Length of Hospital Stay: A Retrospective Observational Study.

BACKGROUND: Refeeding syndrome (RS) is characterized by severe electrolyte derangement that may be associated with worse clinical outcomes in hospitalized patients. In this study, we aim to assess the incidence of RS in inpatients receiving parenteral nutrition (PN) and its possible association with the length of hospital stay (LHS) and mortality. METHODS: We conducted a historical cohort study involving adults receiving PN, monitored by a nutrition therapy team in a Brazilian public hospital. Data collection was made from electronic records. We assessed the presence of RS after PN therapy was initiated. The amount of energy delivered within 72 hours of PN, LHS, and mortality were compared between patients with and without RS. RESULTS: One-hundred ninety-seven patients (aged 57.7 ± 14.1 years; 55.7% men) were followed for a median of 51 days. The incidence of RS was equal to 25.4%. The adequacy of energy delivered in relation to energy requirements within 72 hours (69.4% ± 29.3% vs 61.8% ± 21.6%) was higher in patients with RS than in those without RS (P = .054). The incidence of death was 55.3% and did not differ between groups. The median of LHS was equal to 51.0 (32.0-83.0) days, and it also did not differ between patients with and without RS. CONCLUSION: RS was identified in 25% of patients receiving PN, but it was not associated to mortality and LHS, even when energy delivery was considered in combination to RS.

Amamentação: dificuldades encontradas pelas mães que contribuem para o desmame precoce / Breastfeeding: difficulties found by mothers contributing to early weakness

Objetivo: Identificar as dificuldades encontradas pelas mães na amamentação que contribuem para o desmame precoce. Métodos: Trata-se de uma pesquisa qualitativa do tipo exploratória descritiva, onde foram entrevistadas 10 mães, que amamentam ou amamentaram, com filhos de até um ano e meio. A coleta foi realizada por meio de entrevista semiestruturada. Resultados: Na categoria "Orientação do profissional de enfermagem no pré e pós-parto" a maioria das entrevistadas não teve nenhuma orientação de enfermagem durante a gravidez. Quanto ao tema "O início da amamentação" a maioria relatou ter tido dificuldade na amamentação, com fissuras, dor, mamilo plano, dificuldades na pega do bebê e a demora da descida do leite. Sobre o assunto "Percepção da mulher sobre a amamentação" todas entrevistadas falaram sobre o aumento do vínculo e do prazer e importância de estarem amamentando. Na categoria "Volta da rotina x trabalho" foi referido que as dificuldades, o medo, a insegurança, ansiedade e até mesmo o estresse de ter que voltar a trabalhar, podem prejudicar a amamentação. Conclusões: As principais dificuldades encontradas que contribuem para o desmame precoce são as particularidades com as mamas (em relação às fissuras e à dor), a ansiedade, o estresse, a adaptação no início, a falta de informações e a volta ao trabalho. Fica evidente a importância do papel da enfermagem nesse processo, assegurando uma assistência integral voltada para o conforto e bem-estar do binômio mãe e bebê, visando um atendimento qualificado, humanizado e eficaz, com o intuito de evitar que aconteça o desmame precoce.

Objective: To identify the difficulties encountered by breastfeeding mothers who contribute to early weaning. Methods: This is a descriptive exploratory qualitative research, 10 mothers who breastfed or breastfeed were interviewed, with children up to one year and a half. The collection was performed through a semi-structured interview. Results: In the category "Orientation of the nurse practitioner in the pre and postpartum period" the majority of the interviewees had no nursing orientation during pregnancy. Regarding the topic "The beginning of breastfeeding", most reported having had difficulty in breastfeeding, with fissures, pain, flat nipple, difficulties in taking the baby and delaying the descent of milk. On the subject "Women's perception about breastfeeding" all interviewed talked about the increased bond and pleasure and importance of breastfeeding. In the category "Return of routine x work" was mentioned that difficulties, fear, insecurity, anxiety and even the stress of having to go back to work, may impair breastfeeding. Conclusions: The main difficulties that contribute to early weaning are the particularities with the breasts (in relation to fissures and pain), anxiety, stress, adaptation at the beginning, lack of information and return to work. It is evident the importance of the role of nursing in this process, ensuring a comprehensive care focused on the comfort and well-being of the binomial mother and baby, aiming a qualified, humanized and effective care, in order to prevent early weaning.

O cuidado com a família da criança na unidade oncológica: uma revisão bibliográfica / Caring for the family of the child in the cancer unit: a bibliographic review

Objetivo: O presente estudo tem por objetivo analisar, por meio da produção científica disponível, como é o cuidado com a família da criança na oncologia, os principais sentimentos dos cuidadores e os elementos dos cuidados realizados pela equipe. Metodologia: A metodologia baseou-se em revisão bibliográfica, que buscou nas bases de dados LILACS e BDENF, para a qual foram incluídos artigos científicos em língua portuguesa e disponíveis na íntegra, publicado no período de 2012 a 2018 e que contemplam o objetivo da pesquisa em seu resumo. Resultados: A análise de 14 artigos deu origem a duas categorias: os principais sentimentos dos cuidadores diante da patologia dos filhos e os elementos do cuidado realizado pela equipe de Enfermagem com os familiares. Conclusão: Tais estudos demonstraram que, para alcançar um nível satisfatório de assistência a uma família, é necessário, em primeiro lugar, conhecê-la. Em segundo, construir o vínculo de confiança capaz de inserir a família de maneira espontânea no tratamento da criança. Essa condição de vínculo com a equipe de Enfermagem possibilita o melhor enfrentamento da doença para a família.

Objectives: The present study aims to analyze, through available scientific production, how care is taken with the family of the child in oncology, the main feelings of the caregivers and the elements of the care performed by the team. Methods: The methodology was based on a bibliographic review, which searched in the databases LILACS and BDENF, which included scientific articles in Portuguese language and available in full, published in the period 2012 to 2017 and that contemplate the objective of the research in its Abstract. Results: The analysis of 14 articles gave rise to two categories: the main feelings of the caregivers regarding the pathology of the children and the elements of the care done by the Nursing team with the relatives. Conclusions: Such studies have shown that in order to achieve a satisfactory level of care for a family, it is necessary first to know it. Second, to build the bond of trust able to the family spontaneously in the treatment of the child. This condition of bonding with the Nursing team allows the best coping of the disease to the family.